title: Implementing a court diversion and liaison scheme in a remand prison by systematic screening of new receptions: a 6 year participatory action research study of 20,084 consecutive male remands.
abstract: BACKGROUND
  A mental health needs assessment in the Irish prison population confirmed findings from other jurisdictions showing high prevalence of severe mental illness, including psychosis amongst those newly committed. We implemented a participatory action research approach in order to provide an integrated mental health prison in-reach and court liaison service for this population.
  
  
  RESULTS
  Following extensive consultation, a two stage screening process was developed which was supplemented by an inter-agency referral management system. During the six years 2006-2011, all 20,084 new remands to the main remand prison serving 58% of the national population were screened. Following the first stage screen, 3,195 received a comprehensive psychiatric assessment. Of these 561 (2.8%) had symptoms of psychosis - corresponding to the prior research finding - and 572 were diverted from the criminal justice system to mental health services (89 to a secure forensic hospital, 164 to community mental health hospitals and 319 to other community mental health services).
  
  
  CONCLUSIONS
  We have shown that it is possible to match research findings in clinical practice by systematic screening, to sustain this over a long period and to achieve consistent levels of diversion from the criminal justice system to appropriate mental health services. The sustained and consistent performance of the model used is likely to reflect the use of participatory action research both to find the most effective model and to achieve wide ownership and cooperation with the model of care.
authors.affiliation: National Forensic Mental Health Service, Central Mental Hospital, Dundrum 14, Dublin, Ireland.|Department of Psychiatry, Trinity College, Dublin, Ireland.
authors.forename: Clare
authors.initials: C
authors.lastname: McInerney
authors.affiliation: National Forensic Mental Health Service, Central Mental Hospital, Dundrum 14, Dublin, Ireland.|Department of Psychiatry, Trinity College, Dublin, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Davoren
authors.affiliation: National Forensic Mental Health Service, Central Mental Hospital, Dundrum 14, Dublin, Ireland.|Department of Psychiatry, Trinity College, Dublin, Ireland.
authors.forename: Grainne
authors.initials: G
authors.lastname: Flynn
authors.affiliation: National Forensic Mental Health Service, Central Mental Hospital, Dundrum 14, Dublin, Ireland.|Department of Psychiatry, Trinity College, Dublin, Ireland.
authors.forename: Diane
authors.initials: D
authors.lastname: Mullins
authors.affiliation: National Forensic Mental Health Service, Central Mental Hospital, Dundrum 14, Dublin, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Fitzpatrick
authors.affiliation: National Forensic Mental Health Service, Central Mental Hospital, Dundrum 14, Dublin, Ireland.
authors.forename: Martin
authors.initials: M
authors.lastname: Caddow
authors.affiliation: National Forensic Mental Health Service, Central Mental Hospital, Dundrum 14, Dublin, Ireland.
authors.forename: Fintan
authors.initials: F
authors.lastname: Caddow
authors.affiliation: Irish Prison Service, Dublin, Ireland.
authors.forename: Sean
authors.initials: S
authors.lastname: Quigley
authors.affiliation: Irish Prison Service, Dublin, Ireland.
authors.forename: Fergal
authors.initials: F
authors.lastname: Black
authors.affiliation: National Forensic Mental Health Service, Central Mental Hospital, Dundrum 14, Dublin, Ireland.|Department of Psychiatry, Trinity College, Dublin, Ireland.
authors.forename: Harry G
authors.initials: HG
authors.lastname: Kennedy
authors.affiliation: National Forensic Mental Health Service, Central Mental Hospital, Dundrum 14, Dublin, Ireland.|Department of Psychiatry, Trinity College, Dublin, Ireland.
authors.forename: Conor
authors.initials: C
authors.lastname: O'Neill
keywords: Court diversion; Court liaison; Prison psychiatry; Psychiatric illness; Screening